WASHINGTON, July 31 -- A Congressional oversight committee laid into the FDA and the CDC today for taking so long to finger jalapenos as the culprit of the Salmonella saintpaul outbreak.

"What should have taken hours or days has taken months or more," said Bart Stupak (D-Mich.), chairman of the House Energy and Commerce Subcommittee on Oversight and Investigation, during a hearing to examine the government's response to the outbreak.

He criticized the agencies for single-mindedly pursuing tomatoes as the cause of the trouble while consumers were continuing to be sickened by contaminated jalapeno and Serrano peppers.

But the FDA stuck to its guns, defending its zealous hunt for an index tomato.

"We respectfully disagree that tomatoes weren't involved," added Lonnie J. King, director of the National Center for Zoonotic, Vector-borne and Enteric Diseases at the CDC.

The CDC was unapologetic for sending the FDA on the tomato quest, saying original investigations revealed such a strong link to tomatoes -- 84% of ill people consumed them -- that they were the likely culprit. The CDC determined that that those who consumed tomatoes were seven times more likely to get Salmonella saintpaul than those who did not (P=0.001).

The CDC told the FDA on May 26 that raw tomatoes might be linked to an increasing number of Salmonella saintpaul infections.

After searching obsessively for weeks for an infected tomato, the FDA announced on July 21 that a jalapeno pepper found in a Texas plant was the likely culprit. This week, the FDA said it had traced the outbreak back to jalapeno and Serrano peppers grown at two separate Mexican farms.

"They could have much more rapidly identified that tomatoes were excluded and they could have gotten to the peppers more quickly and saved a lot of people the stress," said William Hubbard, senior adviser for the Coalition for a Stronger FDA.

Stupak -- who clutched a tomato in one hand and a jalapeno pepper in the other -- demanded that the FDA admit it made a mistake in pursuing tomatoes for so long.

A tomato company executive testified that the CDC and the FDA should have had its focus squarely on Mexican produce from the very beginning.

Reginald Brown, executive vice-president for the Florida Tomato Exchange, told the panel that Florida was the only state distributing tomatoes at the time of the outbreak, making the state's tomatoes a prime suspect in the outbreak case.

But the supposedly infected tomatoes were consumed in the southwest, an area that gets its tomatoes from Mexico. Still, the FDA did not switch its focus to Mexico until a tainted jalapeno found in Texas was traced back to a Mexican farm.

"We believe that the FDA erred in not finding the source of this outbreak, and we believe that the FDA erred in not promptly 'releasing' tomatoes from Florida given the fact that the test done on Florida tomatoes showed no sign of Salmonella."

A Minnesota public health official told the panel that his state managed to "unequivocally" implicate jalapenos as the source of infections in their state in about 15 days -- or about half the time it took the federal government.

Using its epidemiology foodborne disease staff, the public health department traced back patient samples that physicians turned into the lab to target one area restaurant. From there, it determined that jalapenos were causing the outbreak on July 8, said Kirk Smith, supervisor of the foodborne, vectorborne and zoonotic disease unit for Minnesota's state Department of Health.

The FDA has said that it has no reason to suspect tomatoes currently on the market bear any trace of the bacteria, but Stupak demanded a more powerful statement than that to restore public trust in the tomato.

"On behalf of tomatoes that want their good name back, you should say something stronger," Stupak told panelist David Acheson, M.D., assistant commissioner for food protection for the FDA.

Brown estimated that Florida's tomato growers and packers lost about $100 million as a result of "the decline in consumer confidence" in Florida tomatoes.

The subcommittee grilled its witnesses on ways to improve how the CDC and the FDA handles outbreaks, and asked if further legislation would help speed the process.

But ultimately, it is not about fast-response time in an outbreak, it is about preventing it in the first place, said Dr. Acheson, who told the panel he'd like stricter preventive controls in the food supply.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco

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